Transformational Trauma and Healing: Dedicated Resources for Brain Injury Survivors

Join Carrie in her conversation with the Brain Injury Association of Maryland's Executive Director, Bryan Pugh. In this episode we discuss the resources available to the brain injury community, as well as the need for more awareness of these resources. 

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Transcript

3:52 - Welcome, Bryan. I am so happy to have you here today.

4:05 - Bryan Pugh It's great to be here.

4:06 - Bryan Pugh I appreciate the opportunity to share with you.

4:08 - Carrie Rickert This is awesome.

4:09 - Carrie Rickert We obviously know each other since I have been a speaker at the Annual Brain Injury Association of Maryland's annual conference a couple of times. And we just did a podcast together on your podcast, The Brain Injury Connector.

4:25 - Bryan Pugh Yep.

4:26 - Bryan Pugh Absolutely. That was great. Absolutely. This is awesome.

4:29 - Carrie Rickert Yeah, so I'll be honest, because until I joined the board for the Hubble Jog Foundation, I hadn't heard of the Brain Injury Association of Maryland, despite being a TBI survivor in the state of Maryland. So for those of us who don't know, can you tell us more about what the Brain Injury Association of Maryland is and what it offers?

4:55 - Bryan Pugh Absolutely. So it is unfortunate, you know, I feel like we are, there are so many best kept secrets in Maryland and we happen to be one of them, unfortunately. We were founded 40 years ago by parents of kids with brain injuries and people that were living with brain injuries and healthcare providers. And back in 1983, there wasn't really a whole lot of information out there. We're talking pre-internet or the beginnings of internet. And so what they decided to do was start an 800 number to try and allow people to call in and at least ask questions so that they could share what they had learned with their experience.

5:38 - Bryan Pugh And so it's one eight hundred two two one six four four three and we have been answering that phone for 40 years. This is our 40th anniversary this year. So, yeah, it's a challenge because when they first started, it was the Maryland Head Injury Foundation. They were around a kitchen table and created this organization. It was, you know, a nonprofit organization to help out families with brain injuries. And almost immediately, they started getting letters Can you fund my research foundation?

6:10 - Bryan Pugh Can you put a ramp in my house foundation? Can you, you know, give me research money or dollars or something foundations like okay, obviously, this is not the right name. So about the same time, the Brain Injury Association of Massachusetts had been founded, and there were several other brain injury associations of other states that had been founded. And so they got together with them and created the Brain Injury Association of America, which is a national organization,

6:42 - Bryan Pugh And then became the Maryland affiliate of the Brain Injury Association of America. And the Brain Injury Association of America continues to this day. And there are currently between I think twenty twenty to twenty five affiliates throughout the United States. There's another group called Brain Injury Alliance. It's also out there and they also have a very similar situation. Branched off from the Brain Injury Association several years ago. And so they tend to be in the Midwest and out West, but it's another wonderful group, you know, that was really solely devoted to try and helping people.

7:23 - Bryan Pugh So we get between 300 and 350 phone calls a month. Which is a lot and, um, yeah, it is a lot. And, and what's really fascinating is when we, when you take a look at it, um, we've done, you know, some, some reporting on this and, uh, I think the last time it was something like there's five area codes in Maryland. And I think our last.

7:28 - Carrie Rickert Um,

7:46 - Bryan Pugh I think our last report, some of the 80, 80 area codes called in or or we're looking for information over the course of the year. And we recognize that a lot of that has to do with, you know, I'm not going to give up my Manhattan area code. I'm going to give it to my children.

8:02 - Carrie Rickert Everybody has cell phones.

8:04 - Bryan Pugh Yeah, everybody got cell phones. We got D.C. Here. We got all the Bethesda and all the national, you know, the bases and the hospitals and all the stuff from all over the world coming to Maryland in their But the reality is we do get phone calls from all over the country. My mom lives in Boston and she's fallen and she needs to move to Maryland because that's where my sister lives. What can we do to get her moved and what kind of stuff do we have to do to my sister's house? Or my brother-in-law lives in Colorado and he can't live by himself anymore.

8:38 - Bryan Pugh You know all kinds of stuff and it's everything.

8:41 - Bryan Pugh You know it's everything from my son's had his third concussion and he won't come out of the basement and he's really you know won't is totally disengaged with the world what do we do to you know mom's had a stroke and we're trying to figure out what to do with her she's experiencing now dementia and you know we're really worried about her falling and things she can't live by herself things like that one of the One of the most increased calls that we're getting now is I'm 80 and my son is 60.

9:14 - Bryan Pugh And I, you know, I can no longer take care of myself. I can no longer take care of my son who was injured when he was 16. You know, we've been, he's been living with us since he had his brain injury and he's,

9:25 - Bryan Pugh You know, or, you know, I'm, you know, I'm going into the hospital and there's nobody to take care of my daughter who lives with me. And those lots of those things where we were experiencing, we've had this huge increase in the longevity of the people with brain injury living, you know, before they'd be, you know, five years, maybe seven years, and then, you know, the healthcare issues would take take you know take them out. But now we're living 20, 30, 40 years, and so we're really experiencing a whole new realm of Um,

10:01 - Bryan Pugh It's like, you know, and it's like, is it, are these issues, is this my brain injury? Is it my personality? Is it, is it age? And and you know and if you try to parse this stuff out, it'll drive you nuts. So my theory is it really doesn't matter. If it you know would I have lost my keys if I didn't have a brain injury? Would I have lost my keys if it wasn't me and I'm a real mess? Would I have lost my keys? Keys if I wasn't now 75. It doesn't really matter. We just got to figure out how to help you not lose your keys, right?

10:32 - Bryan Pugh But it's. And a lot of these questions are getting wrestled with, what's it going to be like,

10:31 - Carrie Rickert Best, Hey?

10:40 - Bryan Pugh Now that I've lived, I've had my brain injury, I've adapted to my brain injury, but now I'm having these other health issues. My vision is going, or my hearing is going, or my balance is going, or I'm starting to really have memory issues. How much of that is my brain injury and how much of that is age. And, you know, we're quite frankly, this is just, this is just new because we just haven't had people live this long with brain injury to really kind of parse it out and figure it out.

11:07 - Carrie Rickert And how interesting, like it did not even occur to me. And I suppose part of that is that I have been so fortunate in that I haven't had to have ongoing care since my brain injury. But my parents are in their 70s, and in 10 years, I would imagine that there is no way they could possibly take care of me if they had still needed to do so.

11:38 - Bryan Pugh Exactly. It's a huge challenge. And one of the things that we're pushing for, and the Brain Injury Association of America is pushing for, is to categorize brain injury you as a chronic condition as a chronic, it's, you know, like stroke is deemed by CMS and CDC as a chronic condition. It will affect you long-term. It will affect many of your health, you know, s bodily health systems. It will require a variety of different treatments, and therefore, the system is set up to do that.

12:10 - Bryan Pugh TBI has not been designated as a chronic condition. In that way, insurance companies don't have to pay for certain things. Certain treatments, certain programs aren't available to individuals with TBI and be able to support them. So we're really Thanks for watching. Sort of over the next couple of years. It's been sort of a groundswell of interest, but we really do need to move it forward to make sure that these folks that are entering into longer-term success and survival with brain injury are going to have access to the different programs, both federal and state programs, insurance, the coverages, you know, that is going to be necessary for them to be able to continue, you know, living independently, living their best lives.

12:53 - Bryan Pugh And that,

12:53 - Carrie Rickert Hey.

12:54 - Bryan Pugh That's a, that's a new movement for us. So uh, you know, get kind of getting back to the history, So we, it was very, you know, over the course of the 40 years, it has been one person, it has been no people, there was only a board. They they had a they had a building and then they had to move out of that building and then they didn't have anybody to run it. So over the course of those 40 years, there's been some up and downs. I became executive director in 2011. And, you know, over the course of, you know, the 12 and a half years that I've been doing it, you know, we've been been lucky enough to grow and continue to grow and be able to contribute to a variety of different areas.

13:38 - Bryan Pugh Right now, we have, you know, the three focuses that were our main focus is our outreach, you know, our information and assistance. So that's going to be the phone calls now we're doing, you know, we respond to social media requests we do. You know, people contact us on Facebook, people contact us on Instagram, people contact us via email. We have... We've got those kinds.

14:00 - Carrie Rickert You have chat features?

14:04 - Bryan Pugh Yeah, we don't have chat features yet. We just don't have it manned yet, or staffed, I should say, staffed yet. But, you know, that may be coming. We're looking at the possibility, you know, there's the pluses and minuses of maybe having an AI. Assistant that can cover at least set things up and do some additional screening so that we can then come back and provide information and assistance for people. Yeah, does they need it. That's really what we try to do because you know You know, if you just have, if you just Google it, you're going to get this massive list and you know what these lists mean.

14:36 - Bryan Pugh So, you know, we try to make sure that we're tailoring it to people, you know,

14:39 - Bryan Pugh What do you need? What do you really need? Yeah. It's just, it's like, I just want a fire hose to get to drink a little bit. I mean, I don't want a fire hose. I don't want a fire hose. I want a little garden hose. Right. And so we try to, we try to make sure that, you know, we're going to, we get enough questions, get enough information to try and make sure that we're going to get you you know, the answers that you want. So that's information assistance. So that's, you know, it's kind of our bread and butter.

15:03 - Bryan Pugh That's what founded the organization. That's what we, we work very hard, developing resources, finding out what kind of, you know, who, who takes this insurance, who doesn't take this insurance, who, who has telemedicine, who doesn't do telemedicine, who, you know, has offices throughout the state, because one of the real challenges of Maryland even though it's a relatively small state, it's a very populated state. And you have this huge variety of people. You have people over in Cumberland, out in the mountains, over in West Virginia.

15:31 - Bryan Pugh You have the ski culture.

15:31 - Carrie Rickert And

15:33 - Bryan Pugh In the winter. And then you have the eastern shore. So you've got very agricultural and then a beach type community. Yeah, you go into the central part of the state and it could be, it could be everything from horse farms to, you know, sunflower farms to all kinds of agricultural farms out there, you know, orchards and things. And then you get closer into the urban setting, you get in closer to DC, you get into Baltimore, and it's very urban. So you have a much different expectation, a much different lifestyle, lots of different questions, different ways you're going to get, you know, you may get a brain injury, you know, it's much likely you're going to, you know, be on an ATV in Bethesda with no helmet and fall off as it would be if you were maybe out in Cumberland riding around the mountain.

16:23 - Bryan Pugh So, you know, there's a huge variety there and that is a challenge to be able to provide answers for everybody. So we try very hard to make sure that we're kind of keeping up with the different resources and different needs. The second piece of our focus is outreach, and that's where we do, you know, our festivals, you know, going to the festivals, health community festivals, we do, we work with, you know, we've worked with churches before, we've worked with African American fraternities and sororities and reaching out into the inner cities.

16:56 - Bryan Pugh We have, you know, done stuff out and we were out in the eastern shore. We've done things in Thurmont, Maryland. I was there two weeks ago at Color Fest to try and just do some brain injury awareness out there. So we do that kind of outreach. And then the third piece is research and promotion of research. And while we may or may, we've done some programs directly with like say Johns Hopkins or the Person-Centered Outcome Research Institute directly. We primarily work with other people that are doing the research and try and generate stakeholders or find if they're looking for individuals with brain injuries in the last five years and try to put them in touch with some of our members and things like that, or if they're doing Thankfully, now there's a trend in moving towards caregiver research, trying to promote the ability for caregivers to have the tools that they need to survive and the knowledge base that they need to help their loved one.

17:48 - Bryan Pugh So we'll find caregivers to put them in touch with different research organizations. PhDs, that are trying to work with people with brain injuries, we try to set them up with folks. So yeah, that's really kind of our third real interest. And that allows us to not only promote research within the brain injury community, but it also allows us to tell our community what's going on, you know, the kind of the cutting edge stuff and keep people apprised of what's going on.

18:19 - Bryan Pugh So those are those are kind of the three legs of our stool. Now we've got, you know, it's, it has evolved, it has changed, we've gotten more sophisticated in some ways. But the bottom line is, it's really about providing, you know, help, hope and healing. On a personal basis, you know, because all of the campaigns we can do and all of the, you know, we have a newsletter, Five Thoughts Friday goes out every Friday. We have, you know, we've had podcasts, of course, we have the website, you know, there's lots of webinars, lots of recordings, lots of things like that.

18:55 - Bryan Pugh And all those are great and absolutely necessary and broadens our reach and broadens our scope, but it's really about that one-to-one conversation. With the mom who is desperate to find some help for her daughter, who.

19:09 - Carrie Rickert Hey.

19:09 - Bryan Pugh You know, is, is really, really struggling with a variety of different issues. And that's really where we shine, I think.

19:19 - Carrie Rickert Well, I mean, it's got to be really challenging because people have so many different needs relative to brain injuries. I mean, first of all,

19:32 - Carrie Rickert How you get a brain injury differs from one person to another, right?

19:38 - Carrie Rickert How severe that brain injury is, whether, you know, you need a caregiver full time or part time and it seems like a lot. Navigate.

19:56 - Bryan Pugh Absolutely, And and it's a, it's a real, it is a challenge, and not only is it a challenge to to the individual who's calling us. Because many times they're calling us, they have talked to everybody. We are the, you know, they have talked to the insurance companies, they have talked to the doctors, they have talked to the therapists, and they are just desperate for something. Sometimes it's just we're desperate for somebody to just listen to me. Because they just don't feel like they're getting, they're getting heard.

20:23 - Bryan Pugh They're not getting seen. They're not getting paid attention to. And so sometimes really just listening and asking pertinent questions, you know, active listening is, is, is, is, you know, palliative is curative in that regard. Just, I felt listened to, I felt like somebody can help me. But one of the great challenges for us is like you said, you know, you come in with this litany of, of issues, because there's so many, you know, and, and sometimes, you know, we have to say, what made you call today?

20:54 - Bryan Pugh What was the thing that you didn't call yesterday, but you called today, something happened to change that dynamic. And so maybe we can take a look at the thing that made you call today, like, you need transportation to your doctor's appointment. Let's talk about that. And then maybe we can come back and sort of work on some of these other long-term issues. And that does require some conversations.

21:22 - Bryan Pugh And the most frustrating thing about it, I think, for me and for our staff, sometimes there just aren't answers. There's just not good answers right now. You know, I, what, who can take, you know, who, my son can't live by themselves. They can't, you know, they're going homeless shelter to homeless shelter, I'm afraid they're going to go to jail or get or worse, you know, get killed on the street. Where can they go? You know, we're in La Plata, or we're in Cumberland, or we're in, you know, Glen Burnie.

21:54 - Bryan Pugh Where can I say, where can I? And and, you know, many times there's just you know, there's just not a great, it's not a great answer. And that's the part that I think we have to watch ourselves because it can really wear you out and wear you down. Listening to these very horrific and gut-wrenching stories and really have, you know, there's really we can, we can sort of try and we can ask and we can call and we can, you know, help you find people to talk to. But in some circumstances, there's just not a great answer right now.

22:30 - Bryan Pugh And that's, that's a real disappointing, you know, part of, I think any social service.

22:36 - Carrie Rickert Yeah, I think so. And, and, you know, with brain injury, it is so difficult because it's not something that people See, right, you know, so people assume and I know that this has happened with me people assume Oh, well, you know, it's been 10 years. She's fine.

23:00 - Bryan Pugh You're so lucky you came back you're fully you're fully right, you know, everything's great, you know, and then unless you have a wheelchair or have some kind of big scar across your face. There's no immediate acknowledge and you may be able to have a conversation for 10-15 minutes, but then go into the parking lot and just bawl your eyes out for an hour and try and be exhausted trying to figure out how to get, where do I get the strength to drive home? Because it takes so much energy and so much effort.

23:27 - Bryan Pugh And then the same thing on the part of the caregiver. I sit down with the doctor for 10 minutes and the individual that's been fighting me and yelling at me and screaming at me and just being totally irrational for the last two weeks, and I'm finally getting into the doctor that's gonna maybe help us. For the 10 minutes that the individual's sitting with them, the doctor says, oh, you look great. Everyone looks fine. Your numbers look good. You look healthy.

23:52 - Bryan Pugh Your weight's good. How are you feeling? I'm feeling great, doc. I'm doing awesome. And you know, and the, and the caregivers just like, Oh my God, no, please, you know, help, help me here. This is, this is not right. And then, you know, one of the more frustrating thing, you know, when you've got individuals with brain injuries who are, they get ignored, the doctor comes in and looks at the, looks at the mom or looks at the wife and doesn't even address that. How are they doing? What are totally blocking them out?

24:20 - Bryan Pugh And that's, that's almost even worse that you just ignore. The person, because it's like, I'm just going to write you off that I know a brain injury. You're incapable of anything. You're incapable of decision making. You're incapable of having emotions and feelings that are rational about the situation. So I'm just going to talk to this person over here. I'm going to talk to your caregiver. And that's even worse, you know,

24:43 - Carrie Rickert For sure. And I will tell you.

24:47 - Carrie Rickert From my own experience, one of the I have such enormous respect for my neuro-interventional radiologist from shock trauma, because he looked right at me and he's like, I want to make sure you understand what the risks are before you choose to have this surgery.

25:11 - Carrie Rickert And I remember thinking, oh, I get to choose?

25:19 - Bryan Pugh Oh,

25:20 - Carrie Rickert You know,

25:20 - Bryan Pugh Right.

25:20 - Carrie Rickert Now, now, granted, I did ask him, like, so what happens if I don't have this surgery? He's like, oh, you'll die. And I'm like, OK, then I guess.

25:30 - Bryan Pugh Wow. OK. Yes. Bedside manner.

25:34 - Bryan Pugh But at least he's being frank. Right.

25:36 - Carrie Rickert Exactly. And he was addressing me. And and I will remember forever how important that was to me because Up until then, I had felt like just a person that some things were happening to, not that I was a person. And

26:03 - Bryan Pugh You're, you're, you're sort of left alone as a bystander, not a participant. It's like,

26:09 - Bryan Pugh I am the participant. We're not talking about somebody else. We're not talking about an academic exercise.

26:14 - Bryan Pugh We're talking about you cutting on me. What happens? What happens if we don't?

26:21 - Carrie Rickert You know, it, it's interesting because my mom who was my primary caregiver during the first part of my recovery, my mom is a retired rehab nurse and ICU nurse. So I was Incredibly lucky because I had an enormous advocate who understood the language.

26:42 - Bryan Pugh You got a mama bear with an RN so back off and watch.

26:46 - Carrie Rickert Except that in some cases, because she knew the language, the conversation was between the doctors and my mom and not, I'm like,

27:01 - Carrie Rickert Wait a minute.

27:02 - Bryan Pugh They could talk to shorthand and they could use the initials and acronyms and it's just right past you.

27:07 - Bryan Pugh It's like, wait, wait, wait, wait, wait.

27:09 - Carrie Rickert Can you tell me what, what we're saying here?

27:11 - Carrie Rickert Cause I'd like to be able to make this decision. And, and fortunately I was capable of making decisions at that time. Um, But I totally understand what you're saying where it is. So important that people with a brain injury have a place to talk to somebody who's going to listen, and to see them and to hear them. And, I mean, gosh, if you were still just answering that 800 number, you would be doing great work. But the fact that you're doing so much more now is, is really, really It's heartwarming and hope-giving.

28:00 - Bryan Pugh Yeah. And that's exactly what was, you know, our founders were trying to do is to, you know, get out and, and yeah, after 40 years, it's very frustrating that people don't know we're here. We, you know, there are people that can't, we're, we have our offices co-located at the university of Maryland rehabilitation and orthopedic Institute, which used to be Kernan hospital right outside the brain injury unit there. And for years, people have walked by. And it's like, you know, never knew we were there.

28:29 - Bryan Pugh And so I was able to get us a window cut into the door so it didn't look like a service closet. But even then, people, you know, really didn't know that we were a resource, and people knew us more outside the hospital than inside the hospital. It's like, I would have people call the hospital and say, now, where are you located? I said, if you go out from where you're calling me, take a left, take a left, knock on my door. Like, what, what it's like,

28:55 - Carrie Rickert You're. Here.

28:55 - Bryan Pugh Yes, I am right. I you know I I can't, you know it's like what you can't be a, can't be a prophet in your own backyard or whatever. It's like, you know, here we are, we're here.

29:03 - Carrie Rickert Great,

29:04 - Bryan Pugh We're here,

29:04 - Carrie Rickert Great,

29:04 - Bryan Pugh Please come find us.

29:06 - Bryan Pugh Yeah, so we try very hard to get out and move and that's, you know, we continue to try to do media, we're trying to do a lot of that, but, you know, so much of what we have, we've been limited by budget, but now we have, you know, we're very blessed with some really great, great support from state contracts and local contracts. And so we try very hard to get out in that regard. And, you know, our We're trying to be a thought leader, you know, that's really a thought leader in this area. And we are in many circles, in the smaller circle of the brain injury, of brain injury community, which you know is pretty tight, pretty tight circle.

29:40 - Bryan Pugh You know, a lot of people do know about us. A lot of people know about our conference, which is in March, Brain Injury Awareness Month. A lot of people have been to that. And that's really kind of our best outreach that we do is our two-day conference. And it's a great, you know, something we're very proud we've been doing it for 37 years, 30 something, 35 years, anyway, a long time. And, you know, it started out very small, you know, in the back of like a golden corral in the back room. And now, you know, we take over the DoubleTree Hotel for two days.

30:14 - Bryan Pugh Bring in everybody from 300 to 400 people. And the beauty of what I think we do, the real difference of what we do, is that many conferences separate between family and individuals with brain injury workshops, and then the conference, the professional health care conference. We continue to try and it's a challenge every year, but we really believe the huge benefit. We create a conference that everybody comes to. We have tracks for individuals with brain injuries over the two days, we have tracks for caregivers over the two days, and then we offer lots of CEUs.

30:55 - Bryan Pugh I think we've got 11 or 12 different professional organizations that we get continuing education units from And it can be between,

31:03 - Bryan Pugh You know, 11 and 12 hours for your license, which is.

31:07 - Carrie Rickert Great.

31:08 - Bryan Pugh But being able to have a you know, genetic researcher from Johns Hopkins sit next to, you know, the mom of an individual with a brain injury or have a, you know, a caseworker from Kennedy Krieger, you know, be able to talk to a person from the CDC. Those kinds of things, you know, it's great. And, you know, one of our favorite things, at least one of my favorite things, is to see people, individuals with brain injuries that are there for the conference. And then you see maybe a shock trauma nurse or you see another rehab nurse watch and see this person walking with their family.

31:47 - Bryan Pugh And they recognize the mom and they recognize the dad and then they're shocked to see the person, the patient. It's like, oh my God, that's John. The last time I saw you, you were wheeling out of shock trauma to go to rehab. I can't believe you're walking. I can't believe you're here. I can't believe you were in such bad shape, but we tried so hard and your parents were so great for you. They have no idea who this person is, but this nurse, this nurse is weeping and hugging their neck and the mom and dad is hugging everybody.

32:14 - Bryan Pugh So I'm like, I can't believe you're Oh, this was your nurse and she was so great and she, you know, and and the person really has no concept because as you know, you know that kind of that part of your history just is a gap and you have to be told by somebody else, because you were physically present but you weren't there. And so, but the family was every night. Oh.

32:33 - Bryan Pugh My gosh, you know, You know, Shirley was your night nurse every night for the three and a half weeks we were there. And we were and she made us she got pillows for us and she got and she made sure that we always had, you know, she would sneak his food and we all you know, and we were tag teaming out and oh my gosh, you know, and it's just awesome. So. It,

32:53 - Carrie Rickert It makes. A

32:54 - Bryan Pugh For us, it's we try to make it It's a family reunion rather than a conference. And I love that piece of it. And you keep doing that when you have that synergy of everybody together,

33:03 - Bryan Pugh The whole community together, the development of you are not alone. You are in this. There is a team. There is a tribe. And you're only going. Get that if you bring everybody together.

33:09 - Carrie Rickert To. And I will say that having attended and spoken at the conference, I absolutely love that about that conference because and had that same situation and that I was standing up talking and then someone came up to me and she's like, I'm sure you don't remember me. But I was your occupational therapist at Sinai for rehab.

33:40 - Bryan Pugh Really, yeah, absolutely.

33:41 - Carrie Rickert Yeah,

33:42 - Bryan Pugh See,

33:42 - Carrie Rickert And She was like,

33:42 - Bryan Pugh That's.

33:43 - Carrie Rickert It is so great to see you and to see how well you've done. And you know,

33:50 - Bryan Pugh And look,

33:51 - Carrie Rickert And

33:51 - Bryan Pugh And she got a piece of that history, you know, here is my patient up talking, talking to, you know, hundreds of other people sharing her story. And I, helped. I was I was I was foundational in that and tell me that doesn't she doesn't carry that back to therapy because who's going to be my next one? You know, who's going to be, you know, you know, you know, Miss Mary, something great's going to happen. And I'm going to make sure that she gets my very best, because I know that Carrie got out there and is now, you know, carrying the flag and out in the front tip of the spear, helping people, you know, it's like, wow.

34:28 - Bryan Pugh Yeah, absolutely. That's what's, it's.

34:31 - Bryan Pugh Just empowering.

34:32 - Carrie Rickert And I would imagine that it is very difficult for doctors and nurses and therapists at places like University of Maryland Shock Trauma, where patients get released and then they don't know the follow up.

34:50 - Bryan Pugh They're off in the ether. Right. Exactly.

34:53 - Bryan Pugh I did my job. I saved your life. And I sent you out into the world and I don't know what happens to you. And because I'm off to the next one, you know,

35:01 - Carrie Rickert And that's so, I mean, exactly like that is. So with the annual conference, I think it is so wonderful that you get to put all those puzzle pieces back together and say, you know what good things did happen because of the good work that you do. You know, that was, that was just such a profound experience, I think, for both me and the occupational therapist, you know, that, like, wow, I had somebody who was that invested in me 10 years ago that she remembered me.

35:39 - Bryan Pugh Right, exactly. And that's so fun, you know, because I just had this experience in Thurmont. We had one of our board of, one of the board of directors, Karen Memphis, is a shark trawler. I don't remember even how many years, she might not even remember how many years, but forever, you know, and is amazing. And so she was having a conversation with one of the artist's wives that was, we were showcasing, and they started talking and you were there when?

36:07 - Bryan Pugh And you were on what floor when? And it's like, oh my gosh, I, I, I would, I'm certain I was your nurse. And then they started, well, we remember a guy named Tony. Oh my gosh, I work with Tony every day. Wow. So, I mean, you know, that connection is out there and available. And again, they, many times those people, both at,

36:30 - Bryan Pugh You know, shock trauma, emergency rooms, and not just shock trauma, but emergency rooms and therapists, you know, the last time they saw you, you were horizontal wheeled out, you know, or you were in a wheelchair leaving the rehab hospital. And they're on to their lives and they're on to the next and they're on to the next and they're on to the next. But they were fully invested. I mean, the people that are in this are so passionate and so giving and loving, and they are so invested in every single person that they do, that it completely makes sense that somebody 10 years later comes back and goes, Carrie, I was your OT.

37:08 - Bryan Pugh I mean, that's just brilliant. Absolutely.

37:09 - Carrie Rickert Brilliant. Awesome. It was so awesome. So Bryan, I want to turn this a little bit, because.

37:16 - Carrie Rickert I want to talk a little bit about your story.

37:19 - Carrie Rickert So what led you to the role of executive director?

37:28 - Bryan Pugh I have been blessed to be married to one of the best neuroscience nurses in the United States. And I say that with confidence because she is on the national board of directors of the American Association of Neuroscience Nurses. So, You know,

37:45 - Carrie Rickert Sup E.

37:46 - Bryan Pugh She is a leader nationally and has been recognized nationally. She's a fellow of the American Heart Association in stroke. She has gotten awards from all over the country for the programs that she has participated in and run. She's got a chapter in the most used nursing textbook in the country. So, you know, I've really kind of been around her career the whole time because we've been pretty much married the whole time she was She's been a nurse. And so.

38:20 - Carrie Rickert Hey.

38:21 - Bryan Pugh I kind of picked it up. I'm trained as an attorney. We lived in the state of Florida for years. I moved us down there to go to law school. We ended up staying there, I think it was 18 years. We had all four of our kids in Tallahassee. We had three and adopted one in Tallahassee where we lived. I did a lot of administrative work. Working for state agencies, doing contract negotiations and a variety of different roles there. There were only two hospitals in Tallahassee. There was the for-profit and the not-for-profit, and she had kind of hit the glass ceiling on the not-for-profit and was looking to sort of expand.

39:03 - Bryan Pugh I had moved us to Florida, so it was really kind of her turn. So she had a real opportunity to come up and become, I think she was stroke coordinator at Sinai Hospital and was recruited to come up to Baltimore for that. And it was one of those situations where.

39:21 - Bryan Pugh The listing on the ad that she was looking at was almost in the order of her resume. I mean, it was just freaky. We need this, we need this, we need this, we need this, we need this. And her experience was this, this, this, this, this. You know, I had done some volunteer work while we were in Florida and had worked on the board of directors of a school for children with dyslexia, so I was familiar with those kinds of things. But we were always a very active family. We were always about introducing our kids to make sure that they knew people with disabilities, were around people with disabilities.

39:56 - Bryan Pugh And so,

39:57 - Bryan Pugh You know, sometimes when there were patients that Sue had, that the person didn't have a family or was lonely or didn't, you know, so we, we were very involved in the lives of some of the patients until they got discharged to make sure that they had, you know, the vitality and we knew that they were loved and appreciated and interested. And it gave our kids an opportunity to to see people in wheelchairs and to see people that were blind and to understand people that have cognitive disabilities.

40:23 - Bryan Pugh My son has fetal alcohol syndrome and autism. So we were living with, you know, my kids were living in and around somebody with some neurological challenges. You know, so we wanted to make sure that he felt fully integrated and they understand that he wasn't just, you know, Trevor wasn't just Trevor, he had, there were lots of other people out there. And so we stayed in that community over time. When we moved up here, you know, I had, I took the bar and I passed the bar up here and had a couple of different jobs, but really wasn't finding anything that was really as fulfilling as I wanted it to be.

41:05 - Bryan Pugh And Sue took, my wife is Sue, Sue took me to a concussion. This was back when concussions were getting, you know, all the rage, kind of tongue in cheek. But it was a concussion seminar run at Sinai Hospital. And the new president of the board of directors of the Brain Injury Association was there. And, you know, he and I struck up a conversation and the executive director had just left and so he was kind of looking for a new executive director, who was who they wanted the board wanted to kind of take us to take take them to the next level.

41:43 - Bryan Pugh They didn't quite know what that meant, but they knew they wanted it to go to the next level because they had they reached a certain amount of notoriety and success and but they were looking to really sort of work it up a notch. So they asked, you know, a lot of the things that they were looking for is things that I had done before, you know, I had done, you know, worked, worked initiatives, I had written contracts, read contracts I had written for the internet, you know, at that point, I was, had worked in the communications and development department for the School of Law, Maryland School of Law for a couple years.

42:18 - Bryan Pugh So I knew about, you know, developing ad campaigns and running events and, you know, writing stuff, articles for the internet and designing websites and things like that. So I kind of had this, and what I liked about it was, is those were things that I really couldn't do as a lawyer. You know, those were pieces and parts of my ability to be creative and to do things that really didn't have very little to do with litigation, had very little to do with, you know, Billable hours and stuff like that.

42:49 - Bryan Pugh So for me, it was like,

42:50 - Bryan Pugh Well, let me take a shot. So I created a five year plan came into the board made a pitch. On the thing on the five things that I think I thought that they. Needed to improve on or had an opportunity to improve on. And then I got the job. I got the job and so in twenty eleven I came in and came in behind a really brilliant executive director who'd been there 10 years, Diane Triplett. And we sort of started building from there. And over the course of the last 12 years, we've kind of moved from When I first took over, it was two people, and then my assistant director left, and so it was just me and a part-time person, and then we've grown now to seven full-time staff over the course of the pandemic.

43:37 - Bryan Pugh And we're doing just amazing things. So, you know, now we, you know, the beauty of that, well, I was looking back, actually, I found my pitch, you know, I found my slide deck from then. And it was just like,

43:48 - Bryan Pugh Wow. So one of my connections, not only, not only through Sue and the neurology and doing that with my family, one of the things that actually happened was my sister was diagnosed with brain cancer, brain tumor, a brain tumor.

44:09 - Bryan Pugh And that really sort of galvanized, you know, my immediate interest in supporting people with brain injuries and the families that were living with them, because I was living through that. And it was really challenging times.

44:24 - Bryan Pugh I mean, you know, she had gone through divorces and personality changes and was going through certain, you know, she was in, she was a master's prepared PT and ran a pool of aqua therapists, and just to watch her sort of mentally decline, emotionally decline. Start just making some really poor decisions and the poor decisions, you know, were impacting my two nephews. And That was a real challenge.

44:54 - Carrie Rickert Yeah,

44:56 - Bryan Pugh So I was, you know, I have both, I've got I've got Trevor that we're, you know, we have on a daily basis to recognize some of the challenges that families face with individuals with neurological challenges. And then my sister had the brain cancer and watching that story unfold both for us and for her family and her situation.

45:20 - Bryan Pugh So that not only fuels, but gives me the perspective from a variety of different, and I think that in talking with people, it allows me to have a perspective that I have some street cred, just for lack of a better term. Because so many times people come in and say,

45:46 - Bryan Pugh You know, this is, you know, I've studied this for years, and this is the other and the reality of it is what I found is with my story, and with, you know, with doing this for a long time, is that everybody knows somebody. Everybody knows somebody, you know, you know, Uncle Charlie, you know, he was such a great guy. And then he has that motorcycle accident. And man, you can't be around him anymore. You don't invite him anything because he's just so angry and he drinks all the time. He's a mean drunk.

46:17 - Bryan Pugh And you can't do that. Or, you know, yeah, we don't talk. We don't go see my my sister anymore since she had her stroke. She's just really difficult to be around. And, you know, it's hard to talk to or, you know, All that stuff. And then you just start looking at you start looking at. Brain injury and mental illness, brain injury and incarceration, brain injury and domestic violence, brain injury. You don't have to peel the onion back too far in any of these situations to start saying, you know, you might not be able to point to a car crash or you might not be able to point to falling off a skateboard or you might not be able to point to a stroke.

47:01 - Bryan Pugh But particularly, but you can see over the course of time, everybody knows somebody that's dealing with this stuff and everybody knows some family that's dealing with it. And many times, you don't know they're dealing with it. You don't know,

47:17 - Bryan Pugh You know, that if you if you talk to them, it's like my mom, She's had three or four TIAs, mini strokes, little strokes. And now we've got this dementia thing going on. And sometimes she knows me and sometimes she doesn't. And sometimes when she knows me, she's really angry. And sometimes she knows me and she's really loving. And it's terrible because she looks the same. She sounds the same. She smells the same. She dresses the same. I don't know who this person is. And it just,

47:54 - Bryan Pugh You know, it's just all consuming. And yet I go to work every day. I go to the church every day. You know, I go to the, to the potluck dinner with all of my friends. I go out to the bowling league every day and know, and you just don't know this stuff is just churning, churning, churning. And

48:13 - Carrie Rickert That's.

48:14 - Bryan Pugh Really amazing.

48:15 - Carrie Rickert That is, you just hit the nail on the head as to why I do this podcast, right? Because I, believe that we spend so much of our lives painting a pretty picture for other people of what the world is supposed to look at, look like, and how we fit into that perfectly. And reality is there isn't a single person in the world who is fitting into that picture perfectly. We're all just making it up.

48:48 - Carrie Rickert And if we spent more time talking with one another and listening to other people's stories and their traumas and their choices and how this has impacted their lives, we would see recognition.

49:14 - Carrie Rickert You know, I mean, you said earlier, people just want to be seen. They want to be seen. And yet we hide ourselves.

49:27 - Bryan Pugh Well, and the other thing,

49:28 - Bryan Pugh Too, I think with. Well,

49:29 - Carrie Rickert National past time. Right.

49:31 - Bryan Pugh And I think social media bleeds into that. I think that's where you get, you know, particularly with all the stuff we're finding out about how the metrics are targeting you and learning about sort of the insidious side of it.

49:40 - Bryan Pugh But the reality is, I am comparing myself to a highly curated mask. That somebody else is putting out there for me that, wow, look how blissful this retirement is. Look at all these amazing places they're doing. Look at all the great graduations they're going to. Look how they're, you know, all these running festivals they're going to. Look at all these music festivals they're going to. Look at how they're getting these selfies with all these amazing, famous people. Um, but you know, then you go back for the 23 hours and 30 minutes of the rest of the day.

50:14 - Bryan Pugh And, you know, they are struggling with drinking. They are struggling with overeating. They are bodies. They are body shamed. They are desperately trying to get accepted that they're fighting for these followers to try and make up a hole in their heart that they can't fill with anything other than attention.

50:30 - Bryan Pugh Um, and, and, and, you know, you're comparing yourself to that. Oh my gosh, my life sucks compared to that. I never post anything because it's never good enough, you know what I mean? But but, but it's a, it's a highly curated mask and so it becomes really challenging and I think particularly with brain injury. And one of the things that's one of the great initiatives that has started is unmasking brain injury. And we got to participate in that. And unmasking brain injury is essentially you give an individual or a family member a blank mask with all of these tools and paints and just paint the mask on it.

51:05 - Bryan Pugh And the best masks that I've seen have the amazing recovery story and the excitement on the outside, and then you turn it on the inside. And it's dark and black and red and just because on the outside you know they present as you know a success story I am a survivor I am a success story of my brain injury but on the inside of the mask, you know, it's, it's. Hell. It's just hell. And there's grief, and there's guilt, and there's survivor's guilt, and there's anger, and there's frustration.

51:38 - Bryan Pugh And the ones that are particularly challenged are the ones that are self-aware. Many times people aren't necessarily self-aware, so they don't know what they've lost. They don't know what they could have, should have, would have. They're not grieving the loss of the person that they think they could have been and they're kind of stuck. But many people are. I used to be able to do this. I used to be able to provide for my family. I used to be able to go to work. I used to be really good, you know, at being an administrative assistant and now I can't even remember to go pick up my prescriptions or I can't remember to go to the doctor's appointment.

52:14 - Bryan Pugh I used to run a multi-million dollar corporation. And, you know, now I, you know, I play guitar for middle schoolers, you know, which is wonderful and blessing and I have a purpose and I have something to do and it's amazing the lives I can change by introducing young people, the things that you can do with a brain injury but the reality is. My identity was removed in one instant.

52:41 - Bryan Pugh And I've got to figure that out. And that can present significant challenges. And that's why people self-medicate with drugs.

52:49 - Bryan Pugh That's why people self-medicate with alcohol. That's why people self-medicate with drugs. Yeah, work, exactly. Just fill it up, fill up that space. So it does, it becomes really challenging. And yeah, and I firmly believe that everybody's dealing with something like that.

53:09 - Carrie Rickert Yeah, I agree. I agree. And I think having these conversations is so important because it allows feel quite as alone.

53:26 - Carrie Rickert I mean, I know that was the biggest, one of the biggest things that I felt I had a ton of support around me, but I thought I was the only one who was dealing with what I was dealing with. And the reality is, is that I wasn't, I just didn't know.

53:46 - Bryan Pugh Yeah, we do a thing called check-in chat on Fridays from 12 to 2. It started from 12 to 1. It started three years ago during COVID. When COVID first started, we sent out a... We sent out a...

53:55 - Carrie Rickert That's awesome.

53:58 - Bryan Pugh A survey to our members, right when it hit, it was like May of 2020. And it's like, you know, what, what can we do to be supportive of you? And they said, you know, I'd like to have some of them would, you know, would like to have a group, not necessarily a support group, just a social gathering, you know. And then other people was like, you know, I'm not really comfortable in groups. I don't do the group thing, but I would love to have somebody to call me up and check in with me. So we started calling a check-in chat.

54:24 - Bryan Pugh Some of the check-ins would be, we'd give you a call and see how you're doing. And then the other, then the check-in chat was this one hour thing that it started out small and then from Maryland. And then once word got out, we were getting people from like five or six different states because there was nothing.

54:39 - Bryan Pugh And so we do that for an hour. We were doing it for an hour for a year. And then people were saying, you know, we really want to have, we do it longer because we're getting more and more people coming. You know, we're getting between, I don't know, 13 and 18 people every time. Can we have a longer time? So we go to two hours. So we went to two hours and what I call it is, you know, the first hour is kind of the check-in chat. And the second hour is more like what I call the parking lot conversation, you know.

55:02 - Bryan Pugh The meeting's broken up. We don't want to leave. We're hanging out in the parking lot, leaning against our cars, just sort of talking about stuff, right? And we've had, I mean, just even last Friday, we had somebody call in from Utah.

55:17 - Bryan Pugh So I mean, people are finding us. And it's like, can I come? It's like, absolutely. And the whole reason we're here is to support people with brain injuries. And it's not really an agenda. I consider it more crowdsourcing. You know, we're all in this together. You're not alone. What are you dealing with? And let's just throw some ideas out there. You know, some things are brilliant and you'll have, you know, I, the example I use is we have one of our individuals has got some short term memory, memory issues.

55:47 - Bryan Pugh And what he did was he took a whiteboard. You know, just a regular tiny white, regular whiteboard, not these big ones, just a smaller one. And then he took motion detector lights, which you can get for like your closet or some of those little disks, you know, battery operated.

56:04 - Bryan Pugh He taped them to the four sides of the whiteboard and he put it in his kitchen, which was the center part of his house. You had to walk past it to do just about anything. And he would write on that whiteboard the thing that he wanted to get done that day or the things that he needed to get done that day. And every time he walked past it, the lights would flash. It catches attention and remind him, this is what you need to get done today. This is what you need to.

56:28 - Bryan Pugh Forget. And and so, yes. And all of a sudden, around the Zoom discussion, light bulbs just like, oh, my gosh, that is absolutely brilliant. I'm going to go to I'm going to go to Office Depot today. Buy me a whiteboard and four motion detector lamps and that's going to be in my kitchen by tonight.

56:51 - Bryan Pugh Those kinds of things. And when we first started out, a lot of it was, you know, how are you getting your shots, your booster shot? How are you getting your COVID vaccines? Because it's really, it was really complicated and it was so much technical and you've got people that are not technologically can't do it. So people are coming up with different ways and others in some states TBI puts you in the front of the list as somebody with a chronic condition and other states, they didn't acknowledge brain injury as being, you know, medically challenged at all and so you were just back in the crowd waiting you know back when we had the had to be over sixty five and a certain, you know, this, these kinds of medical things.

57:27 - Bryan Pugh And then you the second. Tier. Third. Exactly.

57:27 - Carrie Rickert Yep, And then you. Had to. Go sit in the car forever. And lie.

57:32 - Bryan Pugh And then they'd call you in with all that stuff. But I mean, for somebody with a brain injury with cognitive and behavioral stuff, Awesome. A lot to demand of people.

57:41 - Carrie Rickert A lot.

57:42 - Bryan Pugh It was a lot to demand of anybody. And it was certainly somebody who's dealing with sort of cognitive challenges. It was even more so. So, you know, we did, but it's really, it's crowdsourcing and everybody will like, you know, I found this neuro-optometrist who's amazing. Or I found this neuro-ophthalmologist who's fantastic. Or here's how we were able to classify this insurance. This is the insurance code we used to get it through when that insurance code wouldn't work. And so we're just kind of, and then it's also, you know, We've had somebody get married, we've celebrated that, we've had babies born, we've celebrated that, we've had people get jobs, we've had people start companies.

58:21 - Bryan Pugh And again, it's all about sort of coming back in any time, anywhere, anyone. So we've got people that are nine months in and people that are 22 years in post brain injury, and so, and everybody's got a different challenge to talk about but again it's really about that connection. And one of the things I talked about we have. Our 5k race, we just had it two weeks ago, it's called the Scarecrow Classic. And, you know, initially, you know, it's about it's about in the fall, it's in October.

58:53 - Bryan Pugh But you know, you've got the Wizard of Oz, you know, if I only had a brain.

58:56 - Bryan Pugh Scarecrow, but but for me, it wasn't about if I only had a brain, it was really about, um, Again, going back to what I said before, the scarecrow It makes it, you know, he's, he's smart, he's creative, he is, but he's very insecure about his abilities until he is given this piece of paper, he's given this diploma. And after that, the confidence comes and the, you know, he's able to then, you know, wow, you know, really realize that he's had this brain all along. And for me, I believe that, you know, Scarecrow is representative of brain injury, not because of this, if I only had a brain song, but The only difference before and after he was handed that piece of paper, that's all it was, it was a piece of paper, is he was seen.

59:49 - Bryan Pugh And he was acknowledged and he was listened to. And once he was seen and acknowledged and listened to, everything changed for him. And so, so many times, people with brain injuries and families of people with brain injuries,

1:00:07 - Bryan Pugh They are discounted. They are not acknowledged, they have no self-confidence in their abilities, they have no self, they've lost their identity, they have lost their ability to contribute, or at least they perceive this. They feel like they're no longer able to be invited to things because I have uncontrollable outbursts or my son or daughter or husband or wife have uncontrollable up or something. So we're not, we're socially isolating. Yet if you are seen and heard, and paid and acknowledged, it makes all the difference in the world.

1:00:43 - Bryan Pugh And so that.

1:00:43 - Bryan Pugh To me is where the scarecrow classic ideal comes from, is that we are here to see and acknowledge and recognize the value that we still have to contribute, that we've always had to contribute. And it may be different than what we originally envisioned, or it may be different than what would have been had we not had the injury or my loved one had not had the injury. But that doesn't discount all the, hundreds of thousands of things that we can contribute and can continue to contribute.

1:01:12 - Bryan Pugh And we just need to be seen and acknowledged. And so that's, for me, is where, you know, the scarecrow classic idea comes from

1:01:20 - Carrie Rickert I love that. I love that. So before we wrap up today, what kinds of activities and events do you have upcoming?

1:01:30 - Bryan Pugh So as I said, we've just kind of come off of a season of a lot of things. We just did Color Fest in Thurmont, which is a two day festival. We showcased two individuals with brain injuries and the wonderful art that they've created since they've had their brain injury. We just had our Scarecrow Classic 5K. That was in Sykesville. We've got that that was out running out in the beautiful autumn woods. It was great. Great experience. Coming up, you know, we do have a Giving Tuesday campaign that's coming up.

1:01:58 - Bryan Pugh That's the Tuesday after Black Friday. So that'll be that. And then our big, big push is going to be, of course, Brain Injury Awareness Month, which is March. We'll have activities, both in DC and in Annapolis to do brain injury awareness, but then we'll also have our two day conference, which is the 21st and 22nd of March in Pikesville.

1:01:52 - Carrie Rickert I bet.

1:02:20 - Bryan Pugh At the DoubleTree. And that remains our showcase, you know, that remains our showcase. For the community for our community for, you know, we bring people in from all over the country as speakers and as participants, and it remains you know just fantastic gathering of the brain injury community Delmarva. And beyond. And we can, you know,

1:02:44 - Bryan Pugh We can have all kinds of great connectivity there. We have really great sponsors there, the food's good, the spacing is all handicap accessible. We designed the day to make sure that we have a quiet space for individuals that may be getting overwhelmed, you know, so we create up a serenity space so we have that. We've tried in the past to have artists showcase, we may continue to do that. Sometimes it's challenging to To have the artists be able to get to be with us but we do that we continue to check in chat if it's something you know people can come to our website and just check on check in chat.

1:03:18 - Bryan Pugh And then you know the the biggest thing that we do weekly is our is our five thoughts Friday five thoughts Fridays are a newsletter. Letter that we put out every week. We usually do about three stories. It could be brain injury stories, research stories, inspirational stories. And then I do a book recommendation or we do a book recommendation. And then we have a quote of the week to send you off into your weekend to sort of think about and contemplate. And,

1:03:40 - Carrie Rickert And Loss.

1:03:41 - Bryan Pugh And that a lot, you know, it's really interesting. I started it seven years ago as a summer thing because I just got, you know, I got so tired of sending emails, give us money, come to our event, give us money and come to our events. Like Come on, if I see that, you know, I was just so tired of every time that I just felt like every time something with Bryan's name on it comes out, it means the hat's out. And he's back. So I wanted to do something that wasn't, you know, it wasn't just asking for money.

1:04:09 - Bryan Pugh And so I said, OK, I'm going to give myself three months. We're going to see if we can do this. And I'm just going to make sure that I have enough stories, brain injury stories, brain injury-related stories, to cover three stories plus a book plus a you know, plus a quote. I love quotes. That was easy. I had notebooks full of quotes. I still have quotes. I have lots of quotes. And, you know, lo and behold, there was always plenty of brain injury stories, and we're coming up, I think it's, we've done, I think we're at seven and a half years, and never run out of a brain injury story every single week.

1:04:42 - Bryan Pugh There's so much going on,

1:04:45 - Bryan Pugh So much research, so many inspirational stories, you know, we're coming up on a Paralympic year next year, so there's going to be even more stories, you know, about athletes with disabilities, you know, wowing the world and defying the odds and doing amazing things. We've got wonderful research that's going on. So, you know, Five Thoughts Friday, you can go to our website, BIAMD.org, you can click on the blue button, give us your first name, last name, and your email address, and then we send it out on Friday at 9 a.m.

1:05:15 - Bryan Pugh If you don't get the chance to look at it, we send it back to you on Monday, just to make sure you don't miss out on the goodness.

1:05:20 - Carrie Rickert I notice. That.

1:05:21 - Bryan Pugh Then. And then, you know, we have Brain Injury Connector. We're in our fourth season now. You know, you got to participate in it. We loved having you with us, but we continue to try and, you know, put out inspirational stories and wonderful stories too. So that people recognize, you know, I am, I'm not alone. You're not alone.

1:05:38 - Bryan Pugh You're not alone. As a caregiver, you're not alone. As a person with a brain injury, you're not alone. As a teenager with a brain injury, you're not alone. As an old person after a stroke or multiple strokes, you're not alone.

1:05:49 - Carrie Rickert Yeah.

1:05:50 - Bryan Pugh And so, you know, we try to encourage people to, you know, use, use the people ahead of you as inspiration and be a beacon for the people coming behind you. Because, you know, people that, you know, we've talked to so many people, I didn't know you guys are out here. And now, I was in the wilderness for two years, I was in darkness for two years, and I was just miserable and alone and just horrible thoughts and, you know, lots of self medication and, and then just to find out that there is a there, you know, I found my tribe.

1:06:23 - Bryan Pugh I want my tribe to be around me and rally around me and I want to rally others to it because it saved my life and I want to save other people's lives. Changed my life and I want to change other people's lives. And that's been the real blessing of my role to be able to sort of facilitate those folks,

1:06:39 - Bryan Pugh Bring those folks together. You know, and I have, I don't have the direct lived experience of a brain injury, but I've lived, I have the lived experience of loving people and working with people and helping people with brain injury. So yeah, everybody knows somebody and everybody can contribute something. So it's been it's been, it's been a great, it's been a great journey.

1:07:05 - Carrie Rickert Well, we are very grateful that you are here and that the Brain Injury Association of Maryland is here. And again, the website address Uh Baa.

1:07:18 - Bryan Pugh Yeah our website is www dot bi AMD dot org uh our our numbers one eight hundred two two one six four four three we've got an amazing staff, an incredibly smart, young, dedicated, passionate staff that are ready to answer questions or at least find out what they can to help you ask better questions. Sometimes there is no answer to what you're asking. But if we can give you better information to ask better questions, different questions, questions to different people, you know, the crew we've got right now are just phenomenal.

1:07:53 - Bryan Pugh And one of my great pleasures in life is to be able to bask in other people's praise of them because they're, oh my gosh, your folks now are so great. I love, yes, yes, absolutely. You're not going to find, you know, you're not going to find anybody more passionate about trying to help this community than the people we've got on board right now.

1:08:12 - Carrie Rickert That's awesome. That's awesome. Well, thank you so much, Bryan. I really appreciate you stopping by and talking to me today.

1:08:20 - Bryan Pugh Absolutely. Anytime, carry. Out,

1:08:22 - Carrie Rickert We've. Been wonderful.

1:08:22 - Bryan Pugh You know, where you put a microphone in front of me, I'll talk. You know, that's, that's, you know, sometimes that's the danger. You put a microphone in a lawyer's hands, you might not get it back, but you know, I, I'm, I'm always willing to help, always willing to talk.

1:08:35 - Carrie Rickert Well, thank you. I appreciate your time today and look forward to talking to you again at some point.

1:08:40 - Bryan Pugh Absolutely. Thank you.